Disability Insurance Benefit Lawsuit Against Metlife Is Dismissed Due To Claimant's Failure To Comply With Time Deadlines

Connie White waited more than five years to file a lawsuit against MetLife for denial of her disability benefits. The law in Louisiana only provided Ms. White 5 years to file her legal action. The district court dismissed her disability claim and the 5th Circuit court of appeals affirmed the denial. Disability insurance claimants need to take timely action if a claim for disability benefits is denied. Failure to act within strict time lines can result in the inability to pursue a claim in court.

Failing to oppose Metropolitan's Motion for Summary Judgment, White alleges that her case was decided on the basis of her failure as opposed to the merits of her case. And even though the Court ruled to approve the insurer's motion, White was given a second chance to file her opposition. White had 10 days to file an opposing position to the original motion for summary judgment. Never filing anything acknowledging the motion, White, after the fact, claimed that the Court erred in its decision to uphold Metropolitan's decision to deny her long-term disability benefits.

The Fifth Circuit Court of Appeals Agrees to Review White's Case

As a result of her claim, the District Court of Appeals Fifth Circuit agreed to review the District Courts Summary Judgment de novo. White contended that the Court entered its ruling "solely because Metropolitan's motion was unopposed." And while the Court disputed this contention, it claimed that it granted the insurer's motion based on the evidence presented in Metropolitan's summary judgment motion.

The Fifth Circuit ruled that "the district court's ruling was correct on the merits." According to the terms of White's insurance plan, legal action cannot be filed "more than three years after proof of Disability," unless "the area where you live allows a longer period of time to file proof of Disability." In White's case, she let that time period expire. Consequently, her challenge to Metropolitan's benefit denial "was filed too late."

Finding of the Fifth Circuit Court in Connie D. White v. Metropolitan Life Insurance Company

The Circuit Court pointed out that since ERISA doesn't set a specific limitation period, state law applies. In Ms. White's case the law in Louisiana allows 5 years for a lawsuit to be filed. Unable to present a case that proves that Metropolitan did not materially misrepresent itself or its decision to deny White disability benefits or that "extraordinary circumstances" existed, White did not prevail in her appeal. Consequently, the Fifth Circuit Court allowed the District Court's ruling in White to stand. The lesson here is that timely filing of disability lawsuits and answers are imperative to a disability claimant's lawsuit being favourably ruled upon.

About the author: Gregory Michael Dell is an attorney and managing partner of the disability income division of Attorneys Dell & Schaefer. Mr. Dell and his team of lawyers have assisted thousands of long-term disability claimants with their claims against every major disability insurance company. Request a free legal consultation here or call 800-698-9162.

This Week on DIAttorney.com (04/09/2011)

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A District Court ruling issued in New York’s Southern District Court illuminates the importance of understanding the meaning of an “occupation qualifier” and/or an “earnings qualifier” requirement in your long-term disability insurance policy. In general, to qualify for disability under a policy that requires these two prerequisites you must show...

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Citing a financial incentive to cheat, the United States Court of Appeals for the Ninth Circuit recently overruled the decision of CIGNA (CI) to deny disability benefits to a man suffering from chronic fatigue syndrome. For anyone disabled by chronic fatigue or fibromyalgia this is a very supportive case and great law. The court provided five reasons that Cigna abused its discretion by denying disability insurance benefits. Let’s take a close at the case history and the court’s reasoning.

Court orders Citigroup and Metlife to answer discovery request exposing conflict of interest in long-term disability benefit denial

Frequently, a disability attorney finds that additional information is needed before he or she can demonstrate that a conflict of interest has motivated the denial of benefits by an ERISA governed disability insurance company. In order to secure this information, the disability insurance attorney files a Motion to Compel Discovery. In response, the disability insurance company inevitably contests the need to provide this information.

→ Continue reading Court orders Citigroup and MetLife to answer discovery request exposing conflict of interest in long-term disability benefit denial

MetLife ordered to reverse denial of long-term disability insurance benefits

Once again, long-term disability insurance provider Metropolitan Life Insurance Company (MetLife) has been ordered by the court to reverse a long-term disability denial because the Court found the grounds for denying the benefits were arbitrary and capricious. This is a far too common occurrence, and one that disability insurance attorneys see frequently. In MetLife denies long-term disability benefits to a consultant after approving them, we looked at background behind John Lanier's claim.

Now, we are going to look at how Lanier's disability insurance attorney represented him before Judge David M. Lawson of the U.S. District Court, Eastern District of Michigan, Southern division.

→ Continue reading MetLife ordered to reverse denial of long-term disability insurance benefits

MetLife denies long-term disability benefits to a consultant after approving them

In the case we are going to look at, a disability insurance attorney found himself representing a client who believed that Metropolitan Life Insurance Company (MetLife) had wrongfully denied the extension of his long-term disability benefits.  This is a far too common occurrence, and one that disability insurance attorneys see frequently. As we look at this case, you will see that without the representation of a disability attorney, John Lanier would not have received his rightful benefits.

→ Continue reading MetLife denies long-term disability benefits to a consultant after approving them

MetLife must reconsider denial of benefits for former MetLife employee

A recent short-term disability case before the United States Court of Appeals, Seventh Circuit, Chicago, Ill., demonstrates that insurance companies are no friendlier to their own employees than anyone else. Kirsten Majeski worked for Metropolitan Life Insurance Company (MetLife) as a nurse consultant until June 2006 when she began complaining of pain and numbness in her shoulders, arms and hands. She was diagnosed with cervical radiculitis, a disorder of the spinal nerve roots.

Click here to continue reading MetLife must reconsider denial of benefits for former MetLife employee

MetLife abused its discretion when it terminated long-term disability benefits

When Judge Stephen V. Wilson delivered his decision on January 13, 2010, it probably resulted in some mixed feelings for Kelly Lavino. She had hoped for a clear victory in her battle with Metropolitan Life Insurance Company (MetLIfe) to have her long-term disability benefits restored. Instead the judge rendered a decision that may put her at the insurance company's mercy once again.

Lavino had been a project engineer for Malcolm Pitnie, Inc. One of the benefits of employment included coverage under a short-term and long-term disability plan issued by MetLife. This entitled Lavino, if she became and remained disabled, to long-term disability benefits.

Continue reading MetLife abused its discretion when it terminated long-term disability benefits

MetLife terminates long-term disability benefits to woman with fibromyalagia

January 13, 2010 was a good day for Kelly Lavino. U.S. District Court, Central District of California Judge  Stephen V. Wilson ruled that Metropolitan Life Insurance Company (MetLife) wrongfully denied disability benefits and abused its discretion when it decided to terminate Lavino’s long-term disability benefits. Let's review what Judge Wilson considered as he made his decision.

Click here to continue reading MetLife terminates long-term disability benefits to woman with fibromyalagia

10th Circuit Court of Appeals validates MetLife's accidental death and dismemberment denial

Verla Hancock participated in a group benefit plan sponsored by her employer, Intermountain Healthcare. The plan's claim fiduciary was Metropolitan Life Insurance Co. (MetLife). Under the plan, Verla obtained basic life insurance, supplemental life insurance and accidental death and dismemberment coverage (AD & D).

The plan stipulated that in order to benefit from the AD & D coverage, the policy holder had to be 1) Injured in an accident; 2) The accident had to be the sole cause of injury; 3) The accident had to be the sole cause of death; 4) The death had to occur within 365 days of the accident. The District Court found that policy beneficiary Terri Hancock had failed to demonstrate that she had a claim against MetLife for accidental death and dismemberment in her mother's death.

Would Terri Hancock's appeal be successful? Let's look at the facts surrounding Verla Hancock's death.

Click here to continue reading 10th Circuit Court of Appeals validates MetLife's accidental death and dismemberment denial

US Court of Appeals Upholds Denial of Disability Benefits By Metlife

Another case appeared in the U.S. Court of Appeals that highlights the importance of exhausting all the administrative options available before taking a case to court. Additionally, this case demonstrates the importance of a treating physician responding to all requests from a disability insurance company.

What happened here? And what can you learn from this case that could help you win your claim for disability insurance benefits?

First, we will look at the history of the case. Then we will look at the law as the court interpreted it.

Click here to continue reading US court of appeals upholds denial of disability benefits by Metlife

Court Finds MetLife's Denial Of Short-Term Disability Benefits Arbitrary And Capricious

After 18 years of work as a management assistant at Raytheon Company, Dorothy Whitehouse suffered a psychotic episode in the workplace triggered by an experience with her boss and co-workers. The severity of the attack prompted her to immediately schedule an emergency appointment with her therapist, a licensed social worker on August 23, 2007.

Click here to continue reading Court Finds MetLife's Denial Of Short-Term Disability Benefits Arbitrary And Capricious

MetLife's Motion To Dismiss Long-Term Disability Claim For Failure to Exhaust Administrative Remedies Is Denied By Missouri Court

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Click here to continue reading MetLife's Motion To Dismiss Long-Term Disability Claim For Failure to Exhaust Administrative Remedies Is Denied By Missouri Court

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This issue arises far too frequently. Let’s look at Dr. Martinez’ story. There are important lessons for all of us.

Click here to continue reading Late Application Filing Results In MetLife Denying A Physician's Long-Term Disability Claim

MetLife's Denial Of Long-Term Disability Benefits to a Senior Project Manager Suffering From Back Pain Is Reveresed By A Federal Judge

Mrs. Kaufmann was employed as a senior project manager by Siemens Corporation. Mrs. Kaufmann was a member of the long term disability plan through MetLife who was both the administrator and payor of disability benefits. On May 26, 2006, Mrs. Kaufmann stopped working on advice from her treating physician, Dr. Daniel T. Rubino. Because of an unsuccessful diskectomy and laminectomy, Mrs. Kaufman suffered from severe chronic pain. Mrs. Kaufman suffered from progressive back pain, disc protrusion and herniation, stenosis and radiculopathy which led her to seek help from those unsuccessful surgeries.

Click here to continue reading MetLife's Denial Of Long-Term Disability Benefits to a Senior Project Manager Suffering From Back Pain Is Reveresed By A Federal Judge

Metlife's Wrongful Denial Of Long-Term Disability Benefits To A Wells Fargo Employee Is Reversed

Many employees rely on disability insurance benefits if they have been injured or have developed a sickness which prevents them from working. Disability insurance provides individuals with a percentage of his or her typical salary until the employee is able to return to work or turns age 65. However, what employees aren’t usually aware of is that as soon as disability benefits start, the disability insurance company wants them to stop and they will use a wide range of tactics to make that happen.

As a disability attorney who has worked on thousands of long-term disability claims against major insurance companies around the country, I can tell you that insurance company tactics can involve undercover investigations, fact-twisting, and even having bias doctors subjectively determine that you are not disabled as in a recent disability insurance case.

Click here to continue reading Metlife's Wrongful Denial Of Long-Term Disability Benefits To A Wells Fargo Employee Is Reversed

Claimant's Statute of Limitation Non-Compliance Allows MetLife's Denial Of Disability Benefits To Go Unchallenged

Disability Insurance Policies are complicated legal documents that are unfortunately difficult for most individuals to properly understand. While a disability policy is intended to be drafted so that a claimant will clearly understand all of the terms and conditions, a claimant’s misunderstanding can jeopardize a claimant’s right to disability benefits. A recent disability case reveals the importance of complying with a disability policy’s statute of limitations provisions. A statute of limitations is the period of time in which a lawsuit may be filed. Failure to file a lawsuit within the statue of limitations will result in dismissal of a lawsuit. The steps that must be taken in order to obtain disability benefits are not always contained within the disability policy.

Click here to continue reading Claimant's Statute of Limitation Non-Compliance Allows MetLife's Denial Of Disability Benefits To Go Unchallenged

Attorneys Dell & Schaefer Win Long Term Disability Insurance Appeal Against MetLife On Behalf Of Engineer Suffering From Parkinson's

Our client, who suffers from Parkinson’s, was a highly skilled engineer and operations manager for an international corporation before his illness rendered him unable to perform the duties of his occupation. Diagnosed with Parkinson’s years before filing for long term disability benefits under his company’s disability plan, he did everything in his power to work at a job he enjoyed and excelled at. However, the nature of his illness began to take a heavy toll, as symptoms relating to his cognitive functioning began to worsen. Left with little choice, he applied for disability benefits under his company’s short term disability policy in March of 2008. He was approved for short term benefits under the disability policy. However, in October of 2008, when the short term disability benefits were exhausted, MetLife denied his claim for long term disability benefits.

Click here to continue reading Attorneys Dell & Schaefer Win Long Term Disability Insurance Appeal Against MetLife On Behalf Of Engineer Suffering From Parkinson's

MetLife Approves Long Term Disability Benefits for Senior Sales Manager in the Medical Supply Industry

Our client, a Senior Sales Manager for a large medical supply company, was suffering from severe spinal stenosis and an injury to her ulnar nerve following an epidural steroid injection. As a result of these disabling conditions, our client suffered from a multitude of physical problems, which included: loss of range of motion in the neck and shoulders; loss of grip strength of the left hand; numbness, tingling, and burning of the left forearm, extreme sensitivity to cold temperatures or light touch, and constant pain. The only way to provide some relief to the constant pain was through prescription pain killers, which left our client groggy and unable to focus or concentrate fully.

Click here to continue reading MetLife Approves Long Term Disability Benefits for Senior Sales Manager in the Medical Supply Industry

Former Financial Trader Files Lawsuit Against Connecticut General Life Insurance (Metlife) Seeking Lifetime Long-Term Disability Benefits

Attorneys Dell & Schaefer has filed a long-term disability breach of contract lawsuit in federal court against Conneticut General Life Insurance Company (“Connecticut General”) seeking lifetime disability benefits. Our client, a former floor trader on the American Stock Exchange, was disabled due to bipolar disorder, a sickness, from March 1995 until April 2006. In 2004, while our client was totally disabled due to his bipolar disorder, he suffered a hernia injury while carrying a television to his car. Our client ‘s disability policy has been administered by MetLife insurance company, which means that MetLife made the decision to deny his benefits as of age 65.

Click here to continue reading Former Financial Trader Files Lawsuit Against Connecticut General Life Insurance (Metlife) Seeking Lifetime Long-Term Disability Benefits

US Supreme Court Attempts To Clarify The Standard Of Review In Denial Of Long-term Disability Benefits

On June 19, 2008, the Supreme Court of the United States finally issued their opinion in the case of Wanda Glen v. Met Life. In a 6 to 3 decision announced Thursday, the US Supreme Court ruled that benefit denials by such companies must be examined with caution when circumstances suggest a high likelihood that financial considerations affected a benefits decision. While Ms. Glenn won her case and Met Life was ordered to pay long-term disability benefits, the Supreme Court did not make any significant findings that will change the way that Federal courts must interpret disability benefit denials.  The Supreme Court had an opportunity to modify the standard of review to "de novo" (complete review)  in all conflict of interest disability claim denials, however they did nothing to give employees a better chance of securing disability benefits that have been denied.

Click here to continue reading US Supreme Court Attempts To Clarify The Standard Of Review In Denial Of Long-term Disability Benefits

Federal Judge Reverses MetLife's Denial of Disability Benefits

Carolyn Kinser, an employee of Associates First Capital Corporation filed a lawsuit against Met Life for wrongful denial of disability benefits. Ms. Kinser was disabled from her occupation due to bipolar disorder and major depressive order. Ms. Kinser had been under continued care and treatment with the same psychiatrist for more than ten years.

Click here to continue reading Federal Judge Reverses MetLife's Denial of Disability Benefits

MetLife Denial Reversed on Appeal: A Diagnosis of Radiculopathy is Exempt from 24 Month Limitation Period for Neuromusculoskeletal Disorders

Kelly Iley, a pharmacist for Kroger Co, was insured under the company’s group long-term disability policy with Metropolitan Life Insurance Company (MetLife). In June 2001, Ms. Iley was diagnosed with lumbar disc disease.

Ms. Iley stopped working in May 2001 and had a discetomy in July 2001 and a fusion surgery in May 2002. She continued to suffer from back pain and filed a total disability benefits claim in November 2001. MetLife initially approved Ms. Iley’s claim but terminated benefits in July 2004, noting the plan’s 24 month limitation period for neuromusculoskeletal and soft-tissue disorders. On appeal, Ms. Iley’s treating physicians submitted statements that she was totally disabled due to radiculopathies. MetLife upheld its denial of benefits and Ms. Iley filed suit in the U.S. District Court for the Eastern District of Michigan, seeking reinstatement of benefits under the Employee Retirement Income Security Act (ERISA).

Upon reviewing the case, Judge Sean F. Cox found that MetLife ignored Ms. Iley’s treating doctor’s diagnosis of radiculopathy and wrongly denied long-term disability benefits under ERISA. Judge Cox found that the plan’s 24 month limitation period did not apply to Ms. Iley and ordered reinstatement of her benefits. The court also awarded Ms. Iley over $20,000 in attorney fees.

Kelly Iley v. Metropolitan Life Insurance Co., et al., No. 2:05-cv-71237, E.D. Mich.; 2007 U.S. Dist.

About the author: Gregory Michael Dell is an attorney and managing partner of the disability income division of Attorneys Dell & Schaefer. Mr. Dell and his team of disability attorneys have assisted thousands of long-term disability claimants with their claims against every major disability insurance company. Attorney Gregory Dell is a nationally recognized disability attorney and the author of a long-term disability insurance law book published by Thomson Reuters, which is a legal reference for attorneys and judges. For a free consultation, please call 800-828-7583 or use our contact page.

MetLife Ordered to Pay Disability Benefits Beyond 24 Months For a Claimant with Both Mental and Physical Disabilities

Mr. Mark J. Schwartz, an accountant, was insured under his employer’s group disability plan, sponsored by Metropolitan Life Insurance Co. (MetLife), which limits disability benefits for mental illness to 24 months, but to age 65 for a physical disability.

Click here to continue reading MetLife Ordered to Pay Disability Benefits Beyond 24 Months For a Claimant with Both Mental and Physical Disabilities

MetLife's Attempts to Stop Paying Total Disability Benefits After Paying Claimant for 10 Years is Denied

Robert Clarke, a market sales manager for Allstate Insurance Company, stopped working in 1992 due to lumbar spinal stenosis, claiming he was unable to sit, stand, or walk for more than 10 minutes. Mr. Clarke was insured under his company’s group disability plan administered by Metropolitan Life Insurance Co. and was paid total disability benefits as of 1992. After several back fusion surgeries in 1990, 1992, and 1994, MetLife approved Mr. Clarke’s initial claim for benefits. In 2002, after paying total disability benefits for more than 10 years, MetLife decided to terminate Mr. Clarke’s disability benefits and claim that Mr. Clarke could perform sedentary work.

Click here to continue reading MetLife's Attempts to Stop Paying Total Disability Benefits After Paying Claimant for 10 Years is Denied